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Patients prefer the ELLIPTA inhaler over the BREEZHALER inhaler.

Many asthmatic individuals make mistakes when using inhalers that affect the quantity of treatment they receive. Patients with asthma or chronic obstructive pulmonary disease make fewer crucial errors with the ELLIPTA inhaler than conventional dry powder inhalers after reading the patient information leaflet (PIL). This study, published in Respiratory Medicine, evaluated the errors made by asthma patients using placebo BREEZHALER or ELLIPTA inhalers.

This was a randomized, multicenter, open-label, placebo inhaler-handling study with a 2×2 complete block crossover design. Individuals aged 18 years or older with mild-to-moderate asthma were enrolled at three facilities in the Netherlands. Inclusion criteria included inhaler use for 12 weeks before enrolment and inhaler inexperience with BREEZHALER and ELLIPTA. Patients were randomly assigned to the BREEZHALER or ELLIPTA inhaler and assessed for mistakes in the use of both inhalers after 1) reading the PIL, and 2) getting additional guidance from a healthcare professional if an error was made.

A total of 114 asthmatic patients (57.0% female; mean age 55.3%) were evaluated. After reading the PIL, 6% of patients with ELLIPTA and 26% with BREEZHALER made one or more major errors (p< 0.001). With ELLIPTA, 27% of patients made 1 or more overall errors after reading the PIL, compared to 41% with BREEZHALER (p< 0.001). With ELLIPTA, fewer patients needed HCP counseling than with BREEZHALER (25% vs. 32%).

After reading the PIL, fewer patients committed critical and overall errors with the ELLIPTA inhaler compared to the BREEZHALER inhaler. Patients preferred the ELLIPTA inhaler over the BREEZHALER inhaler over the majority of the inhaler qualities tested, thought it to be easier to use across all criteria evaluated, and were more eager to continue using it. 

The reduction and eventual eradication of significant errors after a healthcare professional’s instructions suggest the need for face-to-face guidance, particularly a practical demonstration of correct inhaler use, when introducing a new device. 

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van der Palen, J., Slade, D., Rehal, S., Verma, M., & Plank, M. (2022). A randomized, cross-over study comparing critical and overall errors, learning time, and preference of the ELLIPTA versus BREEZHALER dry powder inhalers in patients with asthma. Respiratory Medicine, 205, 107031. https://doi.org/10.1016/j.rmed.2022.107031